CPT® Code 61690

An arteriovenous malformation (AVM) is a pathological condition characterized by an abnormal connection between the arterial and venous systems, where one or more arteries and veins connect directly without the intermediary of capillaries. This congenital malformation can occur within the intracranial region, leading to significant clinical implications. The direct arterial-to-venous connection results in high-pressure blood shunting into the venous system, which can lead to serious complications, including the risk of vessel rupture and subsequent hemorrhage. The surgical procedure described by CPT® Code 61690 specifically addresses the treatment of a dural AVM, which is located within the dura mater—the tough, fibrous outer membrane that encases the central nervous system. The surgical intervention involves a craniotomy, where scalp flaps are created, burr holes are drilled, and a bone flap is elevated to access the AVM. The procedure requires meticulous dissection to expose the AVM, followed by the identification and ligation of arterial feeders and draining veins. The complete excision of the AVM is critical to prevent future complications, and post-operative angiography is performed to confirm the successful removal of the malformation. This procedure is classified as a simple dural AVM surgery, indicating that the AVM is a smaller mass of vessels without normal vessels incorporated and is not situated in a critical brain region.